The International Association for the Study of Lung Cancer (IASLC) used the platform of the 2019 World Conference on Lung Cancer (WCLC) to call attention to the importance of tobacco cessation after cancer diagnosis and urged all physicians to screen patients with cancer for tobacco use and recommend tobacco cessation.
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Patients with cancer who continue smoking after their diagnosis have a higher mortality rate and a higher risk for a subsequent malignancies. The clinical effects of smoking after the diagnosis of cancer also has a substantial effect on increased cancer treatment costs, according to the Declaration.
The IASLC Tobacco Control and Smoking Cessation Committee has undertaken this initiative to raise physician involvement in tobacco control, said Jacek Jassem, MD, PhD, of the Medical University of Gdansk. “For too long, this has been a neglected problem in the education of health professionals. Many physicians still believe that it is too late to offer smoking cessation support at cancer diagnosis. Likewise, most patients believe that there is nothing to be gained from quitting once being diagnosed,” explained Dr. Jassem.
Key recommendations from the Declaration include:
- All patients with cancer should be screened for tobacco use and advised on the benefits of tobacco cessation
- In patients who continue smoking after diagnosis of cancer, evidence-based tobacco cessation assistance should be routinely and integrally incorporated into multidisciplinary cancer care for patients and their family members
- Educational programs regarding cancer management should include tobacco cessation training, empathetic communication around history of tobacco use and cessation, and utilization of existing evidence-based tobacco cessation resources
- Smoking cessation counseling and treatment should be a reimbursable service
- Smoking status, both initially and during the study, should be a required data element for all prospective clinical studies
- Clinical trials of patients with cancer should consider designs that could also determine the most effective tobacco cessation interventions.
The IASLC Committee partnered with the U.S. Food and Drug Administration, the National Cancer Institute, the American Association for Cancer Research, and ASCO for a small internal meeting discussing the importance of capturing tobacco use status of patients participating in clinical trials. Currently, there are very few prospective clinical trials addressing smoking cessation after cancer diagnosis.
